Surgical access device with fixation mechanism

ABSTRACT

A surgical access device including a cannula body and a fixation mechanism is disclosed. The cannula body includes a housing, and an elongated portion extending distally from the housing and defining a longitudinal axis. The fixation mechanism includes a sleeve and a spring. The sleeve radially surrounds a portion of the elongated portion of the cannula body. The sleeve is rotatable about the longitudinal axis relative to the elongated portion of the cannula body, and the sleeve is longitudinally translatable relative to the elongated portion of the cannula body. A first portion of the spring is engaged with the sleeve, and a second portion of the spring engaged with a distal portion of the elongated portion of the cannula body. Rotation of the sleeve about the longitudinal axis relative to the elongated portion of the cannula body causes a portion of the spring to move away from the longitudinal axis.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a Divisional Application of U.S. patentapplication Ser. No. 16/745,722, filed on Jan. 17, 2020, now U.S. Pat.No. 11,464,540. The entire contents of which is incorporated herein byreference.

BACKGROUND Technical Field

The present disclosure relates to a surgical access device. Moreparticularly, the present disclosure relates to a surgical access devicehaving a fixation mechanism to help maintain its position relative to apatient during a surgical procedure.

Background of Related Art

In minimally invasive surgical procedures, including endoscopic andlaparoscopic surgeries, a surgical access device permits theintroduction of a variety of surgical instruments into a body cavity oropening. A surgical access device (e.g., a cannula) is introducedthrough an opening in tissue (i.e. a naturally occurring orifice or anincision) to provide access to an underlying surgical site in the body.The incision is typically made using an obturator having a blunt orsharp tip that has been inserted within the passageway of the surgicalaccess device. For example, a cannula has a tube of rigid material witha thin wall construction, through which an obturator may be passed. Theobturator is utilized to penetrate a body wall, such as an abdominalwall, or to introduce the surgical access device through the body wall,and is then removed to permit introduction of surgical instrumentationthrough the surgical access device to perform the surgical procedure.

During these procedures, it may be challenging to maintain the positionof the surgical access device with respect to the body wall,particularly when exposed to a pressurized environment. To help maintainthe position of the surgical access device with respect to the bodywall, an expandable anchor or fixation mechanism disposed near a distalend of the surgical access device is occasionally used. Expanding suchan anchor while the surgical access device is within the body helpsminimize undesired movement of the surgical access device with respectto the body.

Accordingly, it may be helpful to provide a fixation mechanism includinga spring to help maintain the longitudinal position of the surgicalaccess device with respect to the patient.

SUMMARY

The present disclosure relates to a surgical access device including acannula body and a fixation mechanism. The cannula body includes ahousing, and an elongated portion extending distally from the housingand defining a longitudinal axis. The fixation mechanism includes asleeve and a spring. The sleeve radially surrounds a portion of theelongated portion of the cannula body. The sleeve is rotatable about thelongitudinal axis relative to the elongated portion of the cannula bodyand is longitudinally translatable relative to the elongated portion ofthe cannula body. A first portion of the spring is engaged with thesleeve, and a second portion of the spring engaged with a distal portionof the elongated portion of the cannula body. Rotation of the sleeveabout the longitudinal axis relative to the elongated portion of thecannula body causes a portion of the spring to move away from thelongitudinal axis. In aspects, the fixation mechanism may include adistal sleeve radially surrounding the distal portion of the fixationsleeve.

In aspects, the fixation mechanism includes a sheath radiallysurrounding the spring. The sheath may radially surround a distalportion of the sleeve and may radially surround a distal portion of theelongated portion of the cannula body.

In aspects, a proximal portion of the spring is affixed to the sleeveand a distal portion of the spring is affixed to the elongated portionof the cannula body.

In additional aspects, the elongated portion of the cannula bodyincludes a locking pin, and the sleeve includes a slot configured toselectively engage the locking pin. Distal movement of the sleeverelative to the elongated portion of the cannula body may cause the slotof the sleeve to disengage the locking pin. A radial position of amid-portion of the spring relative to the longitudinal axis may be ableto be adjusted when the slot of the sleeve and the locking pin of theelongated portion of the cannula body are disengaged.

In aspects, proximal movement of the sleeve relative to the elongatedportion of the cannula body causes the slot of the sleeve to engage thelocking pin. Engagement between the slot of the sleeve and the lockingpin of the elongated portion of the cannula body may secure a radialposition of a mid-portion of the spring relative to the longitudinalaxis.

In aspects, the sheath is made from at least one of a transparentmaterial or a translucent material.

In additional aspects, the spring is a constant force spring.

In aspects, the surgical access device also includes an anchor engagedwith the elongated portion of the cannula body, and disposed proximallyof the spring of the fixation mechanism. The anchor may belongitudinally translatable relative to the elongated portion of thecannula body.

The present disclosure also relates to a fixation mechanism for use witha surgical access device. The fixation mechanism includes a sleeve, aspring, and a sheath. The sleeve defines a longitudinal axis, andradially surrounding a portion of an elongated portion of the surgicalaccess device. The sleeve is rotatable about the longitudinal axisrelative to the elongated portion and is longitudinally translatablerelative to the elongated portion. A proximal portion of the spring isaffixed to the sleeve, and a distal portion of the spring is affixed tothe elongated portion. The sheath radially surrounds the spring.Rotation of the sleeve about the longitudinal axis relative to theelongated portion causes the spring to move from a first position wherea mid-portion of the spring is disposed a first distance from theelongated portion, to a second position where the mid-portion of thespring is disposed a second distance from the elongated portion, thesecond distance being greater than the first distance.

In aspects, the sheath radially surrounds a distal portion of thesleeve, and radially surrounds a distal portion of the elongated portionof the surgical access device.

In aspects, the spring is a constant force spring.

In additional aspects, the sleeve includes a slot configured to engage alocking pin of the elongated portion of the surgical access device tohinder rotation of the sleeve about the longitudinal axis relative tothe elongated portion of the surgical access device.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects of the present disclosure are illustrated herein withreference to the accompanying drawings, wherein:

FIG. 1 is a perspective view of a surgical access device illustrating afixation mechanism in an undeployed configuration;

FIG. 2 is an enlarged view of the area of detail indicated in FIG. 1 ;

FIG. 3 is an assembly view of the surgical access device of FIG. 1 ;

FIG. 4 is a side view of the surgical access device of FIGS. 1-3 withintissue illustrating the fixation mechanism in an undeployedconfiguration and an anchor in a proximal position; and

FIG. 5 is a side view of the surgical access device of FIGS. 1-4 withintissue illustrating the fixation mechanism in a deployed configurationand the anchor in a distal position.

DETAILED DESCRIPTION

Aspects of the presently disclosed surgical access device will now bedescribed in detail with reference to the drawings wherein like numeralsdesignate identical or corresponding elements in each of the severalviews. As is common in the art, the term “proximal” refers to that partor component closer to the user or operator, i.e. surgeon or physician,while the term “distal” refers to that part or component farther awayfrom the user.

Generally, the surgical access device or cannula, often part of a trocarassembly, may be employed during surgery (e.g., laparoscopic surgery)and may, in various aspects, provide for the sealed access oflaparoscopic surgical instruments into an insufflated body cavity, suchas the abdominal cavity. The cannula is usable with an obturatorinsertable therethrough. The cannula and obturator are separatecomponents but are capable of being selectively connected together. Forexample, the obturator may be inserted into and through the cannulauntil the handle of the obturator engages, e.g., selectively locks into,a proximal housing of the cannula. In this initial position, the trocarassembly is employed to tunnel through an anatomical structure, e.g.,the abdominal wall, either by making a new passage through the structureor by passing through an existing opening through the structure. Oncethe trocar assembly has tunneled through the anatomical structure, theobturator is removed, leaving the cannula in place in the structure,e.g., in the incision created by the trocar assembly. The proximalhousing of the cannula may include seals or valves that prevent theescape of insufflation gases from the body cavity, while also allowingsurgical instruments to be inserted into the body cavity.

Additionally, the surgical access device of the present disclosureincludes a fixation mechanism configured to engage tissue to helpmaintain the cannula in its position relative to the body during use.

FIGS. 1-5 illustrate an aspect of a surgical access device according tothe present disclosure. With initial reference to FIG. 1 , the surgicalaccess device 10 includes a cannula body 100 and a fixation mechanism200. The cannula body 100 includes a proximal housing 120 at itsproximal end, and includes an elongated portion 140 extending distallyfrom the proximal housing 120. The elongated portion 140 defines achannel 150 (FIG. 3 ) extending therethrough, and defines a longitudinalaxis “A-A.” An obturator (not shown) is insertable through the channel150 and is engageable with the proximal housing 120, for instance.

With particular reference to FIG. 2 , the fixation mechanism 200 isdisposed in mechanical cooperation with the elongated portion 140 of thecannula body 100, and includes a sleeve 220, a biasing element or spring240, and a sheath 260. As discussed in detail below, the spring 240 isradially adjustable in response to rotation of the sleeve 220 (i.e.,expansion or contraction).

Referring to FIGS. 1-3 , the engagement between the fixation mechanism200 and the cannula body 100 is shown. The sleeve 220 radially surroundsa portion of the elongated portion 140 of the cannula body 100, and isrotatable about the longitudinal axis “A-A” relative to the elongatedportion 140. A first, proximal end 242 of the spring 240 is affixed to adistal portion of the sleeve 220 (e.g., with a first rivet 250), and asecond, distal end 244 of the spring 240 is affixed to a portion of theelongated portion 140 of the cannula body 100 (e.g., with a second rivet252). The sheath 260 radially surrounds the spring 240, a portion of theelongated portion 140, and a portion of the sleeve 220.

The sleeve 220 is rotatable about the longitudinal axis “A-A” relativeto the elongated portion 140 of the cannula body 100. The sleeve 220 isalso longitudinally translatable relative to the elongated portion 140between a first, proximal position where a slot 222 of the sleeve 220engages a locking pin 142 extending radially outward from the elongatedportion 140 (FIG. 5 ), and a second, distal position where the slot 222of the sleeve is disengaged from the locking pin 142 (FIGS. 1, 2 and 4).

More particularly, a predetermined amount of rotation of the sleeve 220about the longitudinal axis “A-A” in a first direction (in the generaldirection of arrow “B” in FIG. 5 ) relative to the elongated portion 140causes a portion (e.g., a mid-portion 246) of the spring 240 to moveradially outward away from the longitudinal axis “A-A” (in the generaldirection of arrows “C” and “D” in FIG. 5 ) and an outer surface of theelongated portion 140, from the first position to the second position.Likewise, a predetermined amount of rotation of the sleeve 220 about thelongitudinal axis “A-A” in a second direction (in the general oppositedirection of arrow “B” in FIG. 5 ) relative to the elongated portion 140causes the portion (e.g., the mid-portion 246) of the spring 240 to moveradially inward toward the longitudinal axis “A-A” and the outer surfaceof the elongated portion 140 from the second position to the firstposition. In aspects, the spring 240 is a single constant force spring,which may enable or facilitate the radial expansion or outward movementof portions of the spring 240.

Additionally, and with continued reference to FIGS. 4 and 5 , distalmovement of the sleeve 220 (in the general direction of arrow “E” inFIG. 5 ) relative to the elongated portion 140 of the cannula body 100causes the slot 222 of the sleeve 220 to disengage from the locking pin142. Further, when the slot 222 of the sleeve 220 is radially alignedwith the locking pin 142, proximal movement of the sleeve 220 (in thegeneral direction of arrow “F” in FIG. 4 ) relative to the elongatedportion 140 of the cannula body causes the slot 222 of the sleeve 220 toengage the locking pin 142. When the slot 222 of the sleeve 220 isengaged with the locking pin 142 (FIG. 5 ), the sleeve 220 is restrictedor prevented from rotating relative to the elongated portion 140 of thecannula body 100. When the slot 222 of the sleeve 220 is not engagedwith the locking pin 142 (FIG. 4 ), the sleeve 220 is free to rotaterelative to the elongated portion 140 of the cannula body 100. Invarious aspects, the sleeve 220 includes a gripping portion tofacilitate rotating and translating the sleeve 220 relative to theelongated portion 140.

In various aspects, the elongated portion 140 includes a single lockingpin 142. Here, one full rotation of the sleeve 220 relative to theelongated portion 140 of the cannula body 100 causes the spring 240 totransition between an undeployed or collapsed configuration (FIG. 4 )and a deployed (or fully deployed) or expanded configuration (FIG. 5 ).

In various aspects, the elongated portion 140 of the cannula body 100may include more than one locking pin 142 extending therefrom. Themultiple locking pins 142 may be radially spaced from each other, andmay correspond to various stages of radial expansion of the spring 240,for instance. In such aspects, the sleeve 220 may include the samenumber of slots 222 as there are locking pins 142.

With particular reference to FIG. 2 , the sheath 260 is affixed to andradially surrounds a distal portion of the sleeve 220, and a distalportion of the elongated portion 140 of the cannula body 100.Additionally, the sheath 260 radially surrounds the spring 240. Thesheath 260 is configured to constrain the spring 240, protect the spring240, and protect tissue from direct contact with the spring 240. Inaspects, the sheath 260 is made from a transparent or translucentmaterial, such as a plastic film or elastomer, which may facilitate avisual inspection of the sleeve 220 and/or the spring 240, for instance.

Referring now to FIGS. 1, 4 and 5 , an anchor 300 is shown. The anchor300 is positionable around the cannula body 100 such that the anchor 300radially surrounds a portion of the elongated portion 140. Moreparticularly, the anchor 300 is longitudinally translatable (in thegeneral direction of arrow “G” in FIG. 5 , and in the oppositedirection) along the elongated portion 140 between a first position,where the anchor 300 is farther away from the distal end 141 of theelongated portion 140 (FIG. 4 ), and a second position, wherein theanchor 300 is closer to the distal end 141 of the elongated portion 140(FIG. 5 ). The anchor 300 may have a frictional engagement with theelongated portion 140 such that the anchor 300 can be pushed/pulled tomove between its first and second positions.

In various aspects, the anchor 300 may be positioned around the sleeve220 of the fixation mechanism 200. Here, the anchor 300 islongitudinally translatable along the sleeve 220 between a firstposition, where the anchor 300 is farther away from a distal end 221 ofthe sleeve 220 (and distally of the slot 222 of the sleeve 220, forinstance), and a second position, wherein the anchor 300 is closer tothe distal end 221 of the sleeve 220.

In use, the distal end 141 of the elongated portion 140 of the cannulabody 100 is inserted into a tissue cavity “TC” while the fixationmechanism 200 is in its undeployed configuration (FIG. 4 ), whichcorresponds to the spring 240 being in a radially contracted position.Next, to move the fixation mechanism 200 to its deployed configuration,which corresponds to the spring 240 being in a radially expandedposition, the user initially pushes or translates the sleeve 220distally relative to the elongated portion 140 in the general directionof arrow “E” (FIG. 5 ) to cause the slot 222 of the sleeve 200 todisengage from the locking pin 142 of the elongated portion 140. Oncethe slot 222 is disengaged from the locking pin 142 (FIG. 4 ), the useris able to rotate the sleeve 220 relative to the elongated portion 140(e.g., in the general direction of arrow “B” in FIG. 5 ). As discussedabove, this rotation of the sleeve 220 causes the spring 240 (or themid-portion 246 thereof) to radially expand into its second position(FIG. 5 ). Next, to lock the spring 240 in its second, radially-expandedposition, the sleeve 220 is moved proximally such that the slot 222engages the locking pin 142 of the elongated portion 140. As notedabove, the elongated portion 142 may have a single locking pin 142 ormultiple locking pins 142, which correspond to various degrees of radialexpansion of the spring 240, for instance. Additionally, prior to movingthe sleeve 220 proximally, the sleeve 220 may have to be rotated (ineither the general direction of arrow “B” (FIG. 5 ) or in the oppositedirection) to align the slot 222 with the locking pin 142.

As shown in FIG. 5 , when the spring 240 is in the second position, thefixation mechanism 200 is within the tissue cavity “C” and is adjacent adistal portion of a tissue wall “TW,” thereby resisting aproximally-directed force acting on the surgical access device 10.

Next, the anchor 300 can be moved distally from its first, proximalposition (FIG. 4 ) to its second, distal position (FIG. 5 ) such thatthe anchor 300 contacts a proximal portion of the tissue wall “TW,”thereby sandwiching the tissue wall “TW” between the anchor 300 and thefixation mechanism 200, and fixing the longitudinal position of thecannula body 100 relative to the tissue wall “TW.”

To remove the surgical access device 10 from contact with tissue, theanchor 300 is moved proximally, the sleeve 220 is moved distallyrelative to the elongated portion 140 to disengage the slot 222 from thelocking pin 142, the sleeve 220 is rotated in the opposite direction ofarrow “B” (FIG. 5 ) relative to the elongated portion 140 to cause thefixation mechanism 200 to move to its first configuration, the sleeve220 may then be moved proximally relative to the elongated portion 140to cause the slot 222 to engage the locking pin 142, and then the distalportion of the surgical access device 10 is removed through the incisionin the tissue wall “TW.”

The present disclosure also relates to a method of deploying thefixation mechanism 200 of a surgical access device 10. The methodincludes translating the sleeve 220 distally relative to the elongatedportion 140 to disengage the slot 222 from the locking pin 142, rotatingthe sleeve 220 in a first direction about the longitudinal axis “A-A”relative to the elongated portion 140 to radially expand the spring 240of the fixation mechanism 200, translating the sleeve 220 proximallyrelative to the elongated portion 140 to engage the slot 222 with thelocking pin 142 to prevent rotation therebetween, translating the sleeve220 distally relative to the elongated portion 140 to disengage the slot222 from the locking pin 142, rotating the sleeve 220 in a seconddirection about the longitudinal axis “A-A” relative to the elongatedportion 140 to radially contract the spring 240 of the fixationmechanism 200, and translating the sleeve 220 proximally relative to theelongated portion 140 to engage the slot 222 with the locking pin 142 toprevent rotation therebetween.

While the above description contains many specifics, these specificsshould not be construed as limitations on the scope of the presentdisclosure, but merely as illustrations of various aspects thereof.Therefore, the above description should not be construed as limiting,but merely as exemplifications of various aspects. Those skilled in theart will envision other modifications within the scope and spirit of theclaims appended hereto.

1. (canceled)
 2. A fixation mechanism for use with a surgical accessdevice, the fixation mechanism comprising: a sleeve defining alongitudinal axis, the sleeve configured to radially surround a portionof an elongated portion of the surgical access device, the sleeverotatable about the longitudinal axis relative to the elongated portionand axially translatable relative to the elongated portion; a spring, aportion of the spring affixed to the sleeve; and a sheath radiallysurrounding at least a portion of the spring, wherein rotation of thesleeve about the longitudinal axis relative to the elongated portioncauses the spring to move from a first position where a mid-portion ofthe spring is disposed a first distance from the longitudinal axis, to asecond position where the mid-portion of the spring is disposed a seconddistance from the longitudinal axis, the second distance is greater thanthe first distance.
 3. The fixation mechanism according to claim 2,wherein the sheath radially surrounds a distal portion of the sleeve. 4.The fixation mechanism according to claim 2, wherein the sheath radiallysurrounds a proximal portion of the spring.
 5. The fixation mechanismaccording to claim 2, wherein the sheath radially surrounds a distalportion of the spring.
 6. The fixation mechanism according to claim 2,wherein the sheath radially surrounds an entirety of the spring.
 7. Thefixation mechanism according to claim 2, wherein the spring is aconstant force spring.
 8. The fixation mechanism according to claim 2,wherein the sleeve includes a slot configured to engage a pin on theelongated portion to hinder rotation of the sleeve about thelongitudinal axis relative to the elongated portion.
 9. The fixationmechanism according to claim 8, wherein distal movement of the sleeverelative to the elongated portion defines a gap between the slot and thepin.
 10. The fixation mechanism according to claim 8, wherein a radialposition of a mid-portion of the spring relative to the longitudinalaxis is adjustable when the slot is spaced apart from the pin.
 11. Thefixation mechanism according to claim 2, wherein a radial position of amid-portion of the spring relative to the longitudinal axis isadjustable.
 12. The fixation mechanism according to claim 2, wherein aproximal portion of the spring is affixed to the sleeve.
 13. A fixationmechanism for use with a surgical access device, the fixation mechanismcomprising: a sleeve defining a longitudinal axis, the sleeve configuredto radially surround a portion of an elongated portion of the surgicalaccess device, the sleeve rotatable about the longitudinal axis relativeto the elongated portion and axially translatable relative to theelongated portion, the sleeve including a slot configured to selectivelyengage a pin of the elongated portion; and a spring, a first portion ofthe spring engaged with the sleeve and a second portion of the springengaged with a distal portion of the elongated portion, wherein rotationof the sleeve about the longitudinal axis relative to the elongatedportion causes a portion of the spring to move away from thelongitudinal axis.
 14. The fixation mechanism according to claim 13,wherein the first portion of the spring is a proximal portion of thespring, and the second portion of the spring is a distal portion of thespring.
 15. The fixation mechanism according to claim 13, furtherincluding a sheath radially surrounding at least a portion of thespring.
 16. The fixation mechanism according to claim 15, wherein thesheath radially surrounds a distal portion of the sleeve.
 17. Thefixation mechanism according to claim 15, wherein the sheath radiallysurrounds an entirety of the spring.
 18. The fixation mechanismaccording to claim 13, wherein a proximal portion of the spring isaffixed to the sleeve.
 19. The fixation mechanism according to claim 13,wherein distal movement of the sleeve relative to the elongated portiondefines a gap between the slot and the pin.
 20. The fixation mechanismaccording to claim 19, wherein proximal movement of the sleeve relativeto the elongated portion causes the slot to engage the pin.
 21. Thefixation mechanism according to claim 13, wherein a radial position of amid-portion of the spring relative to the longitudinal axis isadjustable.